Letters?

I'm an MS-2, seriously considering going into peds, and we just went through our hospital lottery for our rotations during 3rd year. Turns out, I got everything I wanted... except for Peds. Not 1st, 2nd, 3rd... but LAST choice.

I wanted to stay with the main affiliated hospital - in which case, the chairman of the rotation is also the course director of the Peds program. I ended up in an affiliated community hospital (with 1-2 other people, I think). Reviews of the hospital aren't bad, per say, but it doesn't seem like a very busy hospital where i'd be exposed to a lot of different aspects of peds; while the main affiliated hospital is a children's hospital.

From what I understand, letters are an important part of the residency application package. My question is - is it really important <i>who</i> writes the letter? Or, the content of the letter? If I end up doing a SubI in Peds, and get a letter from there during fourth year, would that help?

Thanks all in advance for the advice!

Willy Wonka: "We are the music makers ... and we are the dreamers of dreams."

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2+ Year Member

Jaco -- you definitely could get a letter from your pediatric Sub-I, which is potentially even more important than a letter from your 3rd year Peds Clerkship.

However, I also understand your desire to be in the main hospital -- if anything to get the best exposure to peds that you can. I would suggest asking your track-mates if anyone would be willing to switch spots with you. At my school, I know a fair amount of switching within tracks happens.

5+ Year Member

3 of my 4 letters were from 4th yr rotations. don't worry about it. and, perhaps you'll get more one-on-one attention and teaching at the community program and can get a letter from your attending there. not all letters have to be from big shots!!

3 of my 4 letters were from 4th yr rotations. don't worry about it. and, perhaps you'll get more one-on-one attention and teaching at the community program and can get a letter from your attending there. not all letters have to be from big shots!!

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i think i've calmed down a bit about it. i'm guessing if i work my a$$ off & show enthusiasm & get to know the attendings well, i can get a good letter, right?

also mendel - how did you get 3 letters from 4th year rotations? do all letters have to be submitted before you submit your residency application? (i'm guessing that happens in sept/oct)? can you still submit letters after you've processed the application?

thanks everyone for the advice! good luck everyone with the match!!!

Willy Wonka: "We are the music makers ... and we are the dreamers of dreams."

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7+ Year Member

I was in a similar situation before my peds clerkship. I actually got placed at my last choice (the community hospital) with the added bonus that I would be unable to get a letter from the attendings since the floor attending was the chief resident. Also unswitchable despite pleading.

As it turned out, it was a much better situation that I was at the community hospital. Since I was clearly interested in peds, they let me function semi-autonomously and I was able to shoulder a much larger amount of responsibility for my patients (to the point where the interns were only minimally involved). The students at the university hospital had a lot more scheduled didactic time, whereas I could spend that time doing patient care stuff or even just playing with my patients. Most of my friends at the university hospital ended up being jealous of my month in the boondocks.

The fact that I saw more bread-and-butter pediatrics wasn't a problem - for an initial inpatient pediatrics experience I think it was more helpful to learn how to manage viral gastro and RSV bronchiolitis rather than see the esoterica that seem to be more common at large university hospitals.

The lack of a letter wasn't a big deal - I just got them from elective/subspecialty attendings I worked with 3rd and 4th year. Generally applications require 3, possibly one from your department chair, but they certainly don't all have to be from all-star faculty or peds inpatient rotations.

7+ Year Member

Okay, here's what you do. Pick out the 10 biggest gunners for surgery at your school, and find out who has a late scheduled surg rotation, or surgery at a community hospital. Convince them to take your earlier university hospital surgery rotation in exchange for peds, which they likely won't mind as much doing last.

If you don't have surgery at a good hosp, then do the same thing for medicine (people generally hate having medicine rotations late in the year, and want to do it early).

be persistent. and if ALL of that amounts to nothing, then go see your advisor or someone high up that knows you at your school and constantly visit them until you get what you want. tell them you're willing to trade any rotation for a better peds and tell them why, most importantly. Its your education, and it's not cheap.

10+ Year Member

From what I understand, letters are an important part of the residency application package. My question is - is it really important <i>who</i> writes the letter? Or, the content of the letter? If I end up doing a SubI in Peds, and get a letter from there during fourth year, would that help?

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It is important who writes your letter as well as the content of the letter. But as for the placement of your third year rotation, it doesn't matter that much. Just do well, and then follow it up with a sub-I at the big fancy hospital and get a letter from a big fancy somebody.

At my medical school it was the same situation. All of the pre-pediatricians wanted desperately to do their MS3 clerkship at the big fancy hospital. But the folks 'in the know' nearly universally recommended doing the MS3 rotation at the county hospital (a little easier) and then, if your interest in pediatrics persisted then to follow it up with a sub-I at the big fancy hospital.

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